Open Access(Val‐)Ganciclovir prophylaxis reduces Epstein‐Barr virus primary infection in pediatric renal transplantation
Author(s) -
Höcker Britta,
Böhm Stephan,
Fickenscher Helmut,
Küsters Uta,
Schnitzler Paul,
Pohl Martin,
John Ulrike,
Kemper Markus J.,
Fehrenbach Henry,
Wigger Marianne,
Holder Martin,
Schröder Monika,
Feneberg Reinhard,
KöpfShakib Sabine,
Tönshoff Burkhard
Publication year - 2012
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2012.01485.x
Subject(s) - medicine , chemoprophylaxis , valganciclovir , ganciclovir , transplantation , immunology , incidence (geometry) , viremia , viral load , gastroenterology , virus , human cytomegalovirus , physics , optics
Summary Epstein‐Barr virus (EBV) primary infection constitutes a serious risk for pediatric transplant recipients, particularly as regards the development of EBV‐related post‐transplant lymphoproliferative disease (PTLD). Currently, there is no established prophylactic regimen. We investigated the association between chemoprophylaxis with valganciclovir (VGCV) or ganciclovir (GCV) and the incidence of EBV viremia in EBV‐naïve pediatric renal transplant recipients (R−) who had received a graft from an EBV‐positive donor (D+) and are therefore at high risk of EBV primary infection. In a prospective, multicenter trial ( n = 114), we compared a cohort on chemoprophylaxis ( n = 20) with a similar control cohort without chemoprophylaxis ( n = 8). Over the 1‐year study period, antiviral prophylaxis with VGCV/GCV was associated with a significantly decreased incidence of EBV primary infection: 9/20 patients (45%) in the prophylaxis group experienced an EBV primary infection compared to 8/8 controls (100%) ( P < 0.0001). Chemoprophylaxis was associated with a significantly lower EBV viral load ( P < 0.001). Type or intensity of immunosuppressive therapy did not influence the occurrence of EBV primary infection or the level/persistence of EBV viral load. Chemoprophylaxis with VGCV/GCV is associated with a reduced incidence of EBV viremia in high‐risk pediatric kidney allograft recipients in the first year post‐transplant. (ClinicalTrials.gov number: NCT00963248).